Healthcare Provider Details

I. General information

NPI: 1871114496
Provider Name (Legal Business Name): JESSICA SCHLOTFELDT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N ROBERT T PALMER DR
ELMHURST IL
60126-3434
US

IV. Provider business mailing address

664 REDMOND CT
BENSENVILLE IL
60106-3297
US

V. Phone/Fax

Practice location:
  • Phone: 630-782-1703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.303957
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number049235458
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: